Abstract
Aims: Pulmonary embolism (PE) is a major contributor to the death rate associated with cardiovascular diseases. The objective of this research is to evaluate the efficacy of the PATHOS score in predicting in-hospital mortality in patients diagnosed with pulmonary embolism (PE) in emergency departments (ED).
Methods: The data of patients who were visited in the ED of a third-level healthcare facility, and diagnosed with PE between 2022 and 2023 were analyzed. To examine the value of the PATHOS score in predicting mortality, through the use of Receiver Operating Characteristic (ROC) analysis, the Area Under the Curve (AUC) was determined.
Results: The study was completed with 111 patients. Of these patients, 52 (46.8%) were male and 59 (53.2%) were female. The mean age of the patients was 67.67±16.49. When the cut-off value of PATHOS score in identifying in-hospital mortality was >2, the sensitivity was 70.8%, the specificity was 71.3%, and the positive predictive value was 41.2% and the negative predictive value was 81.9%.
Conclusion: In this study, we concluded that the PATHOS score may be an effective tool for in-hospital mortality estimation of patients diagnosed with PE in the ED. However, this score needs further evaluation in large-scale and multicenter studies.
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References
- Essien EO, Rali P, Mathai SC. Pulmonary embolism. Med Clin North Am. 2019;103(3):549-564. doi:10.1016/j.mcna.2018.12.013
- Doherty S. Pulmonary embolism an update. Aust Fam Physician. 2017;46(11):816-820.
- Martinez Licha CR, McCurdy CM, Maldonado SM, Lee LS. Current management of acute pulmonary embolism. Ann Thorac Cardiovasc Surg. 2020;26(2):65-71. doi:10.5761/atcs.ra.19-00158
- Güler İ, Ustaalioğlu İ. Using the shock index in predicting mortality in patients with pulmonary embolism. South Clin Ist Euras. 2023; 34: 31-5. doi:10.14744/scie.2023.26096
- Jamison DT, Summers LH, Alleyne G, et al. Global health 2035: a world converging within a generation [published correction appears in Lancet. 2014 Jan 18;383(9913):218. Ulltveit-Moe, Karene H [corrected to Ulltveit-Moe, Karen H]]. Lancet. 2013;382(9908):1898-1955. doi:10.1016/S0140-6736(13)62105-4
- Kline JA. Diagnosis and exclusion of pulmonary embolism. Thromb Res. 2018;163:207-220. doi:10.1016/j.thromres.2017.06.002
- Shen JH, Chen HL, Chen JR, Xing JL, Gu P, Zhu BF. Comparison of the wells score with the revised Geneva score for assessing suspected pulmonary embolism: a systematic review and meta-analysis. J Thromb Thrombolysis. 2016;41(3):482-492. doi:10.1007/s11239-015-1250-2
- Surov A. Pulmonary embolism mortality score. Angiology. 2021;72(8):795. doi:10.1177/00033197211026410
- Rohat AK, Kurt E, Şenel Ç. The comparison of two prediction models for ureteral stones: CHOKAI and STONE scores [published correction appears in Am J Emerg Med. 2021 Oct;48:380]. Am J Emerg Med. 2021;44:187-191. doi:10.1016/j.ajem.2020.08.099
- Vargun P, Yilmaz S, Tatliparmak AC et al. Should lactate levels be combined with rapid emergency medicine scores (REMS) to predict outcomes of patients with dyspnea. Signa Vitae 2023. doi:10.22514/sv.2023.024
- Ustaalioğlu İ, Ak R, Öztürk TC, Koçak M, Onur Ö. Investigation of the usability of the REMS, RAPS, and MPM II0 scoring systems in the prediction of short-term and long-term mortality in patients presenting to the emergency department triage. Ir J Med Sci. 2023;192(2):907-913. doi:10.1007/s11845-022-03063-1
- Ak R, Hökenek NM. Comparison of AIMS65 and Glasgow Blatchford scores in predicting mortality in patients with upper gastrointestinal bleeding. Rev Assoc Med Bras (1992). 2021;67(5):766-770. doi:10.1590/1806-9282.20210580
- Spampinato MD, Covino M, Passaro A, et al. Predicting in-hospital mortality in pulmonary embolism patients: development and external validation of the PATHOS score. Clin Exp Emerg Med. 2023;10(1):26-36. doi:10.15441/ceem.22.369
- World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-2194. doi:10.1001/jama.2013.281053
- Konstantinides SV, Torbicki A, Agnelli G, et al. 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism [published correction appears in Eur Heart J. 2015 Oct 14;36(39):2666] [published correction appears in Eur Heart J. 2015 Oct 14;36(39):2642]. Eur Heart J. 2014;35(43):3033-3069k. doi:10.1093/eurheartj/ehu283
- Wendelboe AM, Raskob GE. Global Burden of Thrombosis: Epidemiologic Aspects. Circ Res. 2016;118(9):1340-1347. doi:10.1161/CIRCRESAHA.115.306841
- Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41(4):543-603. doi:10.1093/eurheartj/ehz405
- Nahm FS. Receiver operating characteristic curve: overview and practical use for clinicians. Korean J Anesthesiol. 2022;75(1):25-36. doi:10.4097/kja.21209
- Hoo ZH, Candlish J, Teare D. What is an ROC curve?. Emerg Med J. 2017;34(6):357-359. doi:10.1136/emermed-2017-206735
- Cao R, López-de-Ullibarri I. ROC Curves for the statistical analysis of microarray data. Methods Mol Biol. 2019;1986:245-253. doi:10.1007/978-1-4939-9442-7_11
Abstract
Project Number
-
References
- Essien EO, Rali P, Mathai SC. Pulmonary embolism. Med Clin North Am. 2019;103(3):549-564. doi:10.1016/j.mcna.2018.12.013
- Doherty S. Pulmonary embolism an update. Aust Fam Physician. 2017;46(11):816-820.
- Martinez Licha CR, McCurdy CM, Maldonado SM, Lee LS. Current management of acute pulmonary embolism. Ann Thorac Cardiovasc Surg. 2020;26(2):65-71. doi:10.5761/atcs.ra.19-00158
- Güler İ, Ustaalioğlu İ. Using the shock index in predicting mortality in patients with pulmonary embolism. South Clin Ist Euras. 2023; 34: 31-5. doi:10.14744/scie.2023.26096
- Jamison DT, Summers LH, Alleyne G, et al. Global health 2035: a world converging within a generation [published correction appears in Lancet. 2014 Jan 18;383(9913):218. Ulltveit-Moe, Karene H [corrected to Ulltveit-Moe, Karen H]]. Lancet. 2013;382(9908):1898-1955. doi:10.1016/S0140-6736(13)62105-4
- Kline JA. Diagnosis and exclusion of pulmonary embolism. Thromb Res. 2018;163:207-220. doi:10.1016/j.thromres.2017.06.002
- Shen JH, Chen HL, Chen JR, Xing JL, Gu P, Zhu BF. Comparison of the wells score with the revised Geneva score for assessing suspected pulmonary embolism: a systematic review and meta-analysis. J Thromb Thrombolysis. 2016;41(3):482-492. doi:10.1007/s11239-015-1250-2
- Surov A. Pulmonary embolism mortality score. Angiology. 2021;72(8):795. doi:10.1177/00033197211026410
- Rohat AK, Kurt E, Şenel Ç. The comparison of two prediction models for ureteral stones: CHOKAI and STONE scores [published correction appears in Am J Emerg Med. 2021 Oct;48:380]. Am J Emerg Med. 2021;44:187-191. doi:10.1016/j.ajem.2020.08.099
- Vargun P, Yilmaz S, Tatliparmak AC et al. Should lactate levels be combined with rapid emergency medicine scores (REMS) to predict outcomes of patients with dyspnea. Signa Vitae 2023. doi:10.22514/sv.2023.024
- Ustaalioğlu İ, Ak R, Öztürk TC, Koçak M, Onur Ö. Investigation of the usability of the REMS, RAPS, and MPM II0 scoring systems in the prediction of short-term and long-term mortality in patients presenting to the emergency department triage. Ir J Med Sci. 2023;192(2):907-913. doi:10.1007/s11845-022-03063-1
- Ak R, Hökenek NM. Comparison of AIMS65 and Glasgow Blatchford scores in predicting mortality in patients with upper gastrointestinal bleeding. Rev Assoc Med Bras (1992). 2021;67(5):766-770. doi:10.1590/1806-9282.20210580
- Spampinato MD, Covino M, Passaro A, et al. Predicting in-hospital mortality in pulmonary embolism patients: development and external validation of the PATHOS score. Clin Exp Emerg Med. 2023;10(1):26-36. doi:10.15441/ceem.22.369
- World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-2194. doi:10.1001/jama.2013.281053
- Konstantinides SV, Torbicki A, Agnelli G, et al. 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism [published correction appears in Eur Heart J. 2015 Oct 14;36(39):2666] [published correction appears in Eur Heart J. 2015 Oct 14;36(39):2642]. Eur Heart J. 2014;35(43):3033-3069k. doi:10.1093/eurheartj/ehu283
- Wendelboe AM, Raskob GE. Global Burden of Thrombosis: Epidemiologic Aspects. Circ Res. 2016;118(9):1340-1347. doi:10.1161/CIRCRESAHA.115.306841
- Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41(4):543-603. doi:10.1093/eurheartj/ehz405
- Nahm FS. Receiver operating characteristic curve: overview and practical use for clinicians. Korean J Anesthesiol. 2022;75(1):25-36. doi:10.4097/kja.21209
- Hoo ZH, Candlish J, Teare D. What is an ROC curve?. Emerg Med J. 2017;34(6):357-359. doi:10.1136/emermed-2017-206735
- Cao R, López-de-Ullibarri I. ROC Curves for the statistical analysis of microarray data. Methods Mol Biol. 2019;1986:245-253. doi:10.1007/978-1-4939-9442-7_11
Details
| Primary Language | English |
|---|---|
| Subjects | Emergency Medicine, Chest Diseases, Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Project Number | - |
| Early Pub Date | July 26, 2023 |
| Publication Date | July 28, 2023 |
| Published in Issue | Year 2023 Volume: 5 Issue: 3 |
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